Barely had the BBC headlines trumpeting the achievement of virtually eliminating 2-year waits for NHS treatment in England faded from TV and radio news bulletins before the appalling revelations on worsening cancer treatment times were flagged up.
Figures leaked to the HSJ and shared with BBC’s Newsnight team showed almost a third of a million people (327,000) are on cancer waiting lists in England, almost 40,000 of them waiting for treatment to begin more than 62 days after a GP referral.
Worse still numbers waiting over 104 days have more than doubled in a year, to more than 10,000: in 2018, NHSE said there should be “zero tolerance [of] non-clinically justifiable 104-day delays”.
Despite a ridiculous statement from NHS England, apparently dictated by Department of Health and Social Care spin doctors, diverting attention from the desperate under-resourcing of cancer care by claiming to be investing “billions in extra diagnostic and treatment capacity,” the BBC report quotes Prof Pat Price from Imperial College London warning that:
“The waits for cancer treatment are the worst they’ve ever been – and they’re getting worse. We have to get on and address this crisis. This is an absolute disaster.”
Indeed the most recent official cancer waiting time figures show how far performance has fallen back in the past year, even as the peak of the pandemic has passed.
In the year since April-June 2021 numbers of cancer patients have increased by less than 5% to 676,000: but the number missing the standard for a 2-week maximum wait for a first consultant appointment after an urgent GP referral has rocketed by almost 48%, from 91,000 to 135,000.
Compared to pre-pandemic (April-June 2019) numbers of patients have increased by 15%, but longer than target waits have more than doubled (up 160% from 58,000 to 135,000).
It’s 8 years since services for patients with suspected breast cancer met the target of ensuring 93% receive appointments within 2 weeks.
Nor is it any consolation for NHS England to aim in its elective services recovery plan to restore performance to pre-pandemic levels: one month waits for treatment have not been on target since the summer of 2018, and the proportion within target has continued falling despite reduced numbers of patients.
It’s even worse with the 62-day (two month) target, which has not been met since early 2014: in the past year while numbers of patients have increased by 2% to 43,000, numbers waiting longer than 62 days have increased by 71% to 16,000, and performance is falling back, with just 62% treated within the standard time.
With these figures already in the public domain it’s no surprise that NHS England should not be keen to publish the figures now leaked by the HSJ which show 10,189 of the 327,395 people on the national cancer waiting list – around 3 per cent – had waited 104 days or more, around double the figure from a year ago, with a further 28,406 having waited between 62 and 103 days as of the end of July.
The HSJ notes that one in four of the 42 Integrated Care Systems that now run England’s NHS are reporting performance worse than the national average, although some ICSs in the south east are doing better than average. The Lowdown has warned that most, if not all ICSs face tough targets for so-called ‘efficiency savings’ this year, and the Nuffield Trust’s Sally Gainsbury has estimated these will add up to more than £5 billion, meaning there is minimal scope for investment to address these problems.
But despite the misplaced optimism of the NHS England statement it’s clear cancer care – as only one of a whole range of services in need of improvement – has not been given sufficient priority in an under-funded and over-stretched NHS that has been denied the resources necessary to hit the targets it has been set.
But things are set to get worse rather than better, with chronic staff shortages, hospitals lacking beds for emergency as well as elective admissions. NHS England has also threatened to cut back on its investment in diagnostic technology – a key bottleneck area for cancer care – as a result of government refusal to fund the excess costs of the controversial 2022 NHS pay award.
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